This type of conduct disorder is
characteristically seen in children below the age of 9 or
10 years. It is defined by the presence of
markedly defiant, disobedient, provocative behaviour and
by the absence of more severe dissocial or
aggressive acts that violate the law or the rights of
others. The disorder requires that the overall criteria
for F91 be met: even severely mischievous or naughty
behaviour is not in itself sufficient for diagnosis. Many
authorities consider that oppositional defiant patterns
of behaviour represent a less severe type of conduct
disorder, rather than a qualitatively distinct type.
Research evidence is lacking on whether the distinction
is qualitative or quantitative. However, findings suggest
that, in so far as it is distinctive, this is true mainly
or only in younger children. Caution should be employed
in using this category, especially in the case of older
children. Clinically significant conduct disorders in
older children are usually accompanied by dissocial or
aggressive behaviour that go beyond defiance,
disobedience, or disruptiveness, although, not
infrequently, they are preceded by oppositional defiant
disorders at an earlier age. The category is included to
reflect common diagnostic practice and to facilitate the
classification of disorders occurring in young children.

Diagnostic
guidelines >

The
essential feature of this disorder is a pattern of
persistently negativistic, hostile, defiant, provocative,
and disruptive behaviour,

which is clearly outside
the normal range of behaviour for a child of the same age
in the same sociocultural context, and which does not
include the more serious violations of the rights of
others as reflected in the aggressive and dissocial
behaviour specified for categories F91.0 and F91.2.
Children with this disorder tend frequently and actively
to defy adult requests or rules and deliberately to annoy
other people. Usually they tend to be angry, resentful,
and easily annoyed by other people whom they blame for
their own mistakes or difficulties. They generally have a
low frustration tolerance and readily lose their temper.
Typically, their defiance has a provocative quality, so
that they initiate confrontations and generally exhibit
excessive levels of rudeness, uncooperativeness, and
resistance to authority.

Frequently, this
behaviour is most evident in interactions with adults or
peers whom the child knows well, and signs of the
disorder may not be evident during a clinical interview.

The key distinction from
other types of conduct disorder is the absence of
behaviour that violates the law and the basic rights of
others, such as theft, cruelty, bullying, assault, and
destructiveness. The definite presence of any of the
above would exclude the diagnosis. However, oppositional
defiant behaviour, as outlined in the paragraph above, is
often found in other types of conduct disorder. If
another type (F91.0-F91.2) is present, it should be coded
in preference to oppositional defiant disorder.